The evolving role of interventional pulmonary in the interdisciplinary approach to the staging and management of lung cancer. Part III: Diagnosis and management of malignant pleural effusions

Ken Y Yoneda, Praveen N. Mathur, Stefano Gasparini

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The diagnosis and management of a malignant pleural effusion can be one of the most vexing problems faced by physicians and their patients. Lung cancer is the most common primary tumor of origin with a prognosis that is limited, but variable and correlated with performance status (PS). Therefore, with a poor PS and known advanced lung cancer, establishing whether or not an effusion is malignant might not be necessary. Conversely, identifiable subsets of patients will have a much better survival, and establishing a definitive diagnosis could be of critical importance. In the great majority of cases, a diagnosis can be determined by serial thoracenteses with or without closed pleural biopsy. However, thoracoscopy is increasingly being utilized and can expedite the workup by obviating the need for repeated thoracenteses and/or closed pleural biopsy, while in the same setting providing definitive palliative treatment. Although studies comparing diagnostic and treatment strategies are limited, we will present the available data with the intention of providing the practicing oncologist with a practical strategy for the diagnosis and management of malignant pleural effusions due to lung cancer. The interventional pulmonologist can play an important role from diagnosis to palliation, greatly facilitating the care of patients with malignant pleural effusions.

Original languageEnglish (US)
Pages (from-to)535-547
Number of pages13
JournalClinical Lung Cancer
Volume8
Issue number9
DOIs
StatePublished - Nov 2007

Keywords

  • Performance status
  • Pleural biopsy
  • Pleural effusion
  • Thoracentesis
  • Thoracoscopy
  • Ultrasonography

ASJC Scopus subject areas

  • Cancer Research
  • Pulmonary and Respiratory Medicine

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